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Assisted Delivery

Sometimes during a natural or vaginal delivery , pregnant women may need some help to give birth due to a variety of reasons. Your obstetrician  together with you and your partner will make an informed decision about your available options such as an assisted vaginal delivery.

What is assisted vaginal delivery?

Some pregnant women may experience difficulties during a natural vaginal delivery and may require some assistance. 

Assisted vaginal delivery, also known as instrumental delivery, may occur for the following reasons:

  • When your labour has lasted a long time
  • You or your baby are in distress
  • You are too tired to continue pushing
  • Your baby is positioned head down but facing mom’s abdomen (OP position)

There are two types of assisted vaginal delivery, namely, forceps delivery and vacuum extraction delivery.


How does assisted vaginal delivery work?

An assisted vaginal delivery usually requires the presence of several medical professionals such as, your obstetrician, nurses or midwives, and a paediatrician. Just like a vaginal delivery, an assisted delivery will only work once your cervix has dilated to 10 cm and your baby has descended into the birth canal. 

Pain relief medications such as an epidural or local anaesthesia will be administered, and a catheter may be inserted to drain your bladder to ensure that there is enough space for your baby to pass through the birth canal. An episiotomy or a cut of the perineum may be required to reduce the risks of severe tear.

These are the steps of an assisted delivery:

  • Your obstetrician will examine your cervix to ensure it has dilated to 10 cm and to check that your baby has descended into the birth canal.
  • Either a vacuum cup or forceps is used to assist your delivery.
  • In a vacuum extraction delivery, a suction plastic cup is placed at the top of your baby’s head and gently pulled during your contraction and while you are pushing. This will guide your baby out of the birth canal.
  • In a forceps delivery, two smooth spoon-shaped instruments are placed carefully on either side of your baby’s head. As you are pushing and having a contraction, your obstetrician will gently pull on the baby using the forceps and guide your baby out of the birth canal. 
  • After delivery, any tears will be repaired, and you and your baby will be monitored for any complications from the procedure.

If your baby cannot be delivered safely by instrumental delivery, you will be advised to have a Caesarean section (C-section).

forceps deliveryvaccum extraction delivery

What are the benefits of an assisted delivery?

In general, assisted vaginal delivery, if can be safely performed, is preferred over a C-section as there is a shorter hospital stay and a reduced need for future C-sections. A C-section in the late stage of labour is a more complex operation than a planned C-section and in some circumstances may increase the risk of harm to both you and your baby.

What are the possible complications or risks of an assisted delivery?

An assisted delivery is associated with the following risks:

  • Higher incidence of perineal tearing (vaginal tears)
  • Anal injuries which may result in life-long incontinence issues
  • Pelvic organ prolapse
  • Higher incidence of excess blood loss
  • Injuries to your baby such as scalp lacerations and bruising

However, most babies delivered by assisted vaginal birth are well and do not have any long-term problems.

What are the contraindications of assisted delivery?

There are some pregnant women who are not suited for an assisted delivery, this is especially true in the following circumstances:

  • Baby is premature
  • Baby has not descended into the birth canal
  • Cervix is not dilated to 10 cm
  • Baby is too big to fit through the birth canal
  • Baby has a bleeding or bone disorder

Frequently asked questions

  1. How do I decide between a forceps delivery or a vacuum extraction delivery?
    Your obstetrician together with you and your partner will decide which instrument to use based on clinical circumstances.
  2. Will I need an assisted vaginal birth the next time I give birth?
    Most women have a normal vaginal delivery without needing assistance in their subsequent delivery.

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#09-08 Mount Elizabeth Medical Centre
Singapore 228510

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